Director of Credentialing Operations

Oversee the end-to-end credentialing process, from pre-hire to onboarding and maintenance, ensuring accuracy, timeliness, and compliance across all markets. Work with Talent and Clinical leaders to identify and drive provider cross-licensing initiatives that align supply with patient demand at the state level. Manage provider enrollment with Medicaid and commercial payers, ensuring required documentation and timelines are met to avoid delays in billing or care. Define and implement a contracting strategy, focusing on delegated credentialing, rate negotiations, value-based contracting, and CPT code optimization. Pursue and secure delegated credentialing status, ensure compliance with health plan requirements, and lead audit processes for provider files. Identify bottlenecks and inefficiencies in credentialing workflows; implement systems, tools, and automation to increase throughput and provider readiness. Partner closely with the Business Operations, Talent Acquisition, and RCM teams to maintain visibility on provider status, hiring pipelines, and licensing requirements. Maintain accurate records and ensure adherence to state, federal, and payer-specific credentialing and background check requirements. Build dashboards and tracking mechanisms to measure credentialing timelines, licensing volume, enrollment milestones, and provider readiness metrics.